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Biomedical subjects

B Amor

Publications and source records attributed to B Amor.

At least 181 records · Page 10Linked to original sources
PubMed1986

Sulphasalazine in ankylosing spondylitis: a double blind controlled study in 60 patients.

Sulphasalazine has been reported to be effective in ankylosing spondylitis with peripheral arthritis, but its efficacy in spondylitis is unknown. Thus 60 patients with active ankylosing spondylitis without peripheral arthritis or gastrointestinal symptoms were randomly allocated to one of two therapeutic groups. One group received 2 g sulphasalazine daily for six months and the other a placebo. Thirteen patients (six given placebo and seven given sulphasalazine) dropped out of the trial and were considered to be treatment failures. After six months' follow up efficacy was rated as good or very good by 15 of the 30 patients given sulphasalazine and by only six of the 30 given placebo (p less than 0.02). Furthermore, in the patients given sulphasalazine the daily consumption of non-steroidal anti-inflammatory drugs, functional index, and plasma IgG concentrations had fallen significantly. These data suggest that sulphasalazine may be a safe and effective treatment for spondylitis in ankylosing spondylitis.

Clinical Trials as Topic↗
PubMed1986

Nifedipine and thallium-201 myocardial perfusion in progressive systemic sclerosis.

Heart disease in patients with progressive systemic sclerosis may be due in part to myocardial ischemia caused by a disturbance of the coronary microcirculation. To determine whether abnormalities of myocardial perfusion in this disorder are potentially reversible, we evaluated the effect of the coronary vasodilator nifedipine on myocardial perfusion assessed by thallium-201 scanning in 20 patients. Thallium-201 single-photon-emission computerized tomography was performed under control conditions and 90 minutes after 20 mg of oral nifedipine. The mean (+/- SD) number of left ventricular segments with perfusion defects decreased from 5.3 +/- 2.0 to 3.3 +/- 2.2 after nifedipine (P = 0.0003). Perfusion abnormalities were quantified by a perfusion score (0 to 2.0) assigned to each left ventricular segment and by a global perfusion score (0 to 18) for the entire left ventricle. The mean perfusion score in segments with resting defects increased from 0.97 +/- 0.24 to 1.26 +/- 0.44 after nifedipine (P less than 0.00001). The mean global perfusion score increased from 11.2 +/- 1.7 to 12.8 +/- 2.4 after nifedipine (P = 0.003). The global perfusion score increased by at least 2.0 in 10 patients and decreased by at least 2.0 in only 1. These observations reveal short-term improvement in thallium-201 myocardial perfusion with nifedipine in patients with progressive systemic sclerosis. The results are consistent with a potentially reversible abnormality of coronary vasomotion in this disorder, but the long-term therapeutic effects of nifedipine remain to be determined.

Adult↗
PubMed1986

Reduced coronary flow and resistance reserve in primary scleroderma myocardial disease.

The maximum coronary vasodilator capacity after intravenous dipyridamole (0.14 mg X kg-1 X min-1 X 4 minutes) was studied in seven patients with primary scleroderma myocardial disease and compared to that of seven control subjects. Hemodynamic data and left ventricular angiographic data were not different in the two groups. The coronary flow reserve was evaluated by the dipyridamole/basal coronary sinus blood flow ratio (D/B CSBF) and the coronary resistance reserve by the dipyridamole/basal coronary resistance ratio (D/B CR). Coronary reserve was greatly impaired in the group with primary scleroderma myocardial disease: D/B CSBF was lower than in the control group (2.54 +/- 1.37 vs 4.01 +/- 0.56, respectively; p less than 0.05) and D/B CR was higher than in the control group (0.47 +/- 0.25 vs 0.23 +/- 0.04, respectively; p less than 0.05). Such a decreased coronary flow and resistance reserve in patients with primary scleroderma myocardial disease was not explained by an alteration of left ventricular function. It may be an important contributing factor in the pathogenesis of primary scleroderma myocardial disease.

Adult↗
PubMed1986

Defective Epstein-Barr virus specific suppressor T cell function in progressive systemic sclerosis.

Several immunoregulatory defects of Epstein-Barr virus (EBV) induced B cell activation have been described in patients with rheumatoid arthritis (RA), suggesting that EBV may have a role in the pathogenesis of RA. We assessed EBV specific T cell regulation in 20 patients with progressive systemic sclerosis (PSS) and immune to EBV and in 10 control subjects also immune to EBV by comparing the secretion of IgM into supernatants of 16 day cultures of B cells alone and cocultures of B and autologous T cells. In control subjects autologous T cells mediated a significant decrease in the secretion of IgM by B cells at 12 and 16 days of culture. Analysis of individual responses showed the existence of two subgroups of patients with PSS: group I (10 patients) had a suppressor T cell function similar to that of controls; group II (10 patients) had a defective T cell function. Differences in the duration or severity of the disease, the slow acting therapeutic agents, and anti-inflammatory drugs could not account for these subdivisions. These results suggest that several immunoregulatory defects of EBV induced B cell activation exist in different connective tissue diseases.

B-Lymphocytes↗
PubMed1986

Pharmacodynamic effect of dipyridamole on thallium-201 myocardial perfusion in progressive systemic sclerosis with diffuse scleroderma.

We evaluated the effect of dipyridamole on thallium-201 myocardial perfusion in 23 patients with progressive systemic sclerosis (PSS) with diffuse scleroderma. Thallium-201 single photon emission computed tomography (SPECT) was performed at rest and after coronary artery vasodilatation with intravenous dipyridamole (0.14 mg/kg/min for four minutes). The left myocardium was divided into nine segments; each segment was graded as 2.0, 1.5, 1.0, 0.5, 0 (zero represents no activity). Dipyridamole significantly improved resting thallium-201 myocardial perfusion: the mean (SD) number of segments with thallium defects decreased from 6.0 (2.1) at rest to 4.1 (2.5) after dipyridamole (p less than 0.0001); the mean (SD) score in segments with resting defects increased from 0.92 (0.24) at rest to 1.13 (0.38) after dipyridamole (p less than 0.0001); the mean (SD) global score per patient increased from 10.2 (1.8) at rest to 11.4 (2.1) after dipyridamole (p less than 0.02); the global score increased by at least 2.0 in 12 patients and worsened by at least 2.0 in three patients only (p = 0.05). The results of this acute study suggest that some drugs with potent vasodilator activity on small coronary arteries may be beneficial in the treatment of PSS patients with thallium-201 myocardial perfusion abnormalities.

Adult↗
PubMed1986

The induction of human antinuclear antibodies by D-penicillamine: activation of inducer helper T cells in the absence of irradiation sensitive suppressor T cells.

The capacity of D-Penicillamine (DP) to induce or to potentiate the production of antinuclear antibodies (ANA), detected by immunofluorescence (IF), was investigated in vitro, using peripheral blood mononuclear cells (PBMC) from patients with systemic lupus erythematosus (SLE) and normal individuals. Except in one patient with SLE, DP did not enhance ANA synthesis when using unseparated PBMC. In contrast, when B cells were cocultured with irradiated T cells or irradiated enriched T4+ subset, DP induced or potentiated the production of ANA. These results indicate that DP acts by stimulating T4+ helper cells to promote ANA synthesis in the absence of radio-sensitive suppressor T cell function contained within the T4+ population.

Antibodies, Antinuclear↗
PubMed1986

[Double-blind study of the treatment of disc lumbosciatica by chemonucleolysis].

A randomized, double-blind study was made of 39 patients with discolumbar hernias that were unresponsive to medical treatment. They were treated either by nucleolysis with chymopapain (4 000 U of discase), or by discography followed by injection of distilled water as a placebo. After one month, treatment was found to be successful in 55% of cases undergoing nucleolysis and in 26% of cases receiving the placebo. The results after 3 months were 65% and 42%. respectively. After one month, the intensity of lumbar pain decreased by 44% on average in the group treated by chymopapain, and by 0% in the placebo group. Radicular pain decreased by 53% in the first group and by 26% in the placebo group, and improvement in Lasègue's sign was 51% and 20%, respectively. Analgesic treatment was reduced in patients treated by chymopapain: 65% of patients in the first group report some or much improvement in their sciatica, whereas this figure was 26% in the placebo group (p less than 0.02). Contralateral sciatica was observed in 3 patients of the placebo group. The average give in the disc one month after nucleolysis was 34% in the chymopapain group and 27% in the placebo group, without correlation with the clinical result. On average, patients were monitored for one year after nucleolysis, and during this year 6 patients from the chymopapain group were operated upon, compared with 10 patients from the placebo group. Although these results are at the limit of statistical significance because of the number of patients studied, they confirm the innocuousness and effectiveness of chymopapain in the treatment of discolumbar hernias.

Adult↗
PubMed1986

Defective IL2 production in active rheumatoid arthritis. Regulation by radiosensitive suppressor cells.

The production of interleukin 1 (IL1) and interleukin 2 (IL2) by mononuclear cells (MNC) from untreated rheumatoid arthritis (RA) patients or healthy subjects were examined. After PHA stimulation, patient MNC or T cells produced varying amounts of IL2 that were related to the disease activity: patients suffering from active disease showed a scant production of IL2 while those who had a quiescent disease were high producers. The prior irradiation of unfractionated MNC induced a marked increase of the PHA-stimulated IL2 production in both active and quiescent patients compared to the moderate augmentation observed for controls. On the other hand, irradiation of enriched T cells had an enhancing effect only in the active RA patient group. Concurrently, we found that non T cells from active or quiescent RA patients were fully competent to produce IL1 upon LPS activation. Taken together, these findings suggest that the suppressive activity evidenced by irradiation could be mediated by non T cells in quiescent disease or in absence of illness. On the other hand, both radiosensitive suppressor T and non T cells may interfere in IL2 production by active RA patient lymphocytes.

Adult↗
PubMed1986

D-penicillamine: a modulator of anti-DNA antibodies production.

The effect of D-Penicillamine (DP) on the in vitro production of anti-DNA antibodies by peripheral blood mononuclear cells (PBMC) from patients with systemic lupus erythematosus (SLE) and from healthy individuals was studied. Anti-DNA antibodies were measured in culture supernatants using a sensitive microenzyme-linked immunoassay technique. The results of this investigation suggest that DP can act as an immunomodulator capable of potentiating or initiating anti-DNA antibodies synthesis as well as suppressing it. Although PBMC from both SLE patients and controls were responsive to this thiol compound, our results indicate that PBMC from patients with SLE were more susceptible to the enhancing effect of DP than did PBMC from controls. The cellular mechanism by which this drug can modulate anti-DNA antibodies production is discussed.

Antibodies, Antinuclear↗
PubMed1986

Experimental autoimmune spondylodiscitis in rats.

Immunization of Lewis rats with nucleus pulposus in incomplete Freund's adjuvant, followed by in vivo injury of nucleus pulposus, induced spondylodiscitis characterized by mononuclear cell infiltration affecting the vertebral discs in 100% of experimental animals. Injury of the nucleus pulposus without prior immunization, or immunization without injury failed to induce spondylodiscitis. The nucleus pulposus, that is not antigenic normally, can lose its immunologic tolerance by the injection of syngeneic nucleus pulposus. When immunocompetent cells come into contact with the nucleus pulposus after tissue injury, an autoimmune response may appear.

Animals↗
PubMed1986

[Osteoarticular pathology, hypercalcemia and adrenal insufficiency. Analysis of 113 cases of adrenal insufficiency].

Rheumatologic manifestations, ectopic calcification and hypercalcemia of adrenal insufficiency (IS) were evaluated by a prospective study (S1) of 20 patients with IS and a retrospective analysis of 93 cases of IS (S2). When routine investigations were conducted they revealed very frequent osteoarticular lesions (19 of 20 cases, S1). Painful manifestations (arthralgia, myalgia), variable with fluctuations in the IS affection were observed in both groups (S1, S2). Analysis of group S1 showed a high number of periarthritic attacks (9 of 20 cases), and a significantly higher incidence of tendinous calcifications (p less than 0.03) and of multiple tendinous calcification disease (MCTM) (p less than 0.05) in relation to 20 matched controls. This combined affection MCTM-IS has not been reported previously. Calcification could be due to glucocorticoid deficiency, the only common factor for all cases, and the frequent calcification of ear pinna (greater than 30% of cases in the 2 groups) could be related to the same deficiency. Finally, reported in the 81 case-reports were 18 episodes of hypercalcemia, emphasizing the unrecognized frequency of this disturbance whose determining role is unclear.

Adrenal Insufficiency↗
PubMed1986

Increased expression of Epstein-Barr virus receptor on lymphoblastoid cell lines from subsets of patients with rheumatoid arthritis.

We studied the expression of Epstein-Barr virus receptor (EBVR/CR2) on lymphoblastoid cell (LCL) lines established from 23 patients with rheumatoid arthritis and the T cell suppression of IgM secretion by EBV activated B cells. Ten patients had normal T cell suppression of IgM secretion, whereas 13 patients had defective suppressor T cell function. EBVR expression on LCL was assessed using a rabbit anti-gp 140 IgG; Raji cells, used as reference cell line expressed 50,000 EBVR, a 140 k glycoprotein (gp 140). Patients with defective T cell suppression of IgM secretion by EBV activated B cells had a significantly higher EBVR expression on LCL than patients with normal T cell suppression (mean +/- SD; 50.8 +/- 23.8 vs 29.5 +/- 13.2, respectively; p less than 0.05). These data suggest a relationship between the T cell suppression defect and an increased EBVR expression on LCL from patients with RA.

Arthritis, Rheumatoid↗
PubMed1986

[Tiopronine and rheumatoid polyarthritis].

This article summarises the authors' experience and the data of the literature concerning Tiopronine, a drug with a thiol function like D-penicillamine, in the treatment of rheumatoid arthritis. Two controlled trials versus placebo and two controlled trials versus D-penicillamine demonstrated the effectiveness of treatment and the identical action of 1 g of Tiopronine and 600 mg of D-penicillamine. The side effects of Tiopronine are very similar to those of D-penicillamine: essentially rash, toxiderma, aguestia, proteinuria, which resolve when treatment is stopped. Patients with a past history of side effects with D-penicillamine have an increased risk of developing side effects with Tiopronine, but this risk is not systematic, which constitutes the principal value of this drug.

Adrenal Cortex Hormones↗
PubMed1986

[Mycobacterial infection of the hip following total prosthesis. Study of 6 cases].

The authors present 6 cases of mycobacterial infection of the hip after total hip replacement: 5 cases of tuberculosis and 1 case of Mycobacterium fortuitum infection. They emphasise the clinical, radiological, bacteriological and histological signs which are generally very characteristic and unequivocal. A review of the literature reveals the rarity of these infections, but stresses the need for a complete bacteriological survey to avoid missing the diagnosis. A routine medicosurgical therapeutic approach is proposed.

Adult↗